消化内镜消毒灭菌效果的影响因素分析与质量管理探究

The analysis of effective factors and quality management in the sterilization of gastrointestinal endoscopy

目的 探究消化内镜消毒灭菌效果的影响因素及其质量的管理.方法 通过采集2015年6月至2016年11月我院使用过的340套消化内镜,包括十二指肠镜,食管镜,胃镜,小肠镜,大肠镜以及胆管镜等的消毒灭菌情况,进行监测统计及分析对比,探究消化内镜消毒灭菌效果的影响因素,从而进行有效的质量管理.结果 医院在严格执行《内镜清洗消毒技术规范》中的要求后,消化内镜消毒灭菌合格率显著与执行标准化要求前比较,差异具有统计学意义（P〈0.05）.结论 在实际操作之中,消化内镜的消毒灭菌工作具有诸多的影响因素,包括消毒灭菌的操作流程不完善、责任护士工作不够细致、医护人员对于内镜消毒液的监测管理不恰当、不细致,以及消毒灭菌不彻底等.而消化内镜的消毒灭菌工作质量不高,容易造成医源性感染的发生,威胁患者健康.根据标准积极改善质量管理,可以有效地提高消化内镜消毒灭菌的合格率,适宜在临床上推广使用.

Objective To explore the influencing factors and quality management of disinfection and sterilization of diges- tive endoscope. Methods From June 2015 to November 2016, 340 sets of digestive endoscopy which including duodenal en- doscopy, esophageal endoscopy, endoscopy, enteroscopy, colonoscopy and choledochoscope etc were selected. And the disin- fection and sterilization status of these sets were accounted and analyzed. The efficacy of disinfection and sterilization were investigated and effective quality management were carried out. Results After the technical specification for cleaning and disinfection of endoscope were strictly enforced, the quality of disinfection and sterilization was improved compared with that of before the adoption of standardized flow （P〈0.05）. Conclusion In the actual operation, disinfection and sterilization of di- gestive endoscopy has many impact factors, including the imperfection sterilization process, the meticulous work of the charge nurses, the inappropriate and meticulous monitor management of the endoscopic disinfection solution by medical staff, and the incomplete of the sterilization, and so on. If the quality of disinfection and sterilization work for digestive endoscopy is not high, it is easy to cause the occurrence of iatrogenic infection, which could threatening the health of patients. So to ana- lyze the reasons and positively improve the quality management according to the standard can effectively improve the qualifi- cation rate of digestive endoscopy sterilization, which is suitable for use in clinical practice.